Canada prescription pipeline drying up.

Charles Barker, 75, comes to Melbourne every few weeks to pick up his mail-order prescription medications.

Parker gets them from Canada to save more than $300 a month. He lived in Palm Bay for more than 50 years but is moving to the Panhandle.

When he checked his post office box recently, though, he didn't get his three-month supply of glaucoma medicine. Instead, he found a letter from the U.S. Food and Drug Administration saying his medicine had been confiscated.

He never got it back. Barker's pharmacy in Canada had to resend it to him. He hopes it doesn't get intercepted again.

"If it was marijuana, fine, grab it," Barker said, adding that all of his prescription notes are from a doctor in Melbourne. His wife, Ava, also gets her medicines from Canada.

"These are the same drugs I can get at a local pharmacy, but there, I would pay twice the price," Charles Barker said.

Experts say what the Barkers experienced was a "spot check." But many retirees and others without insurance are finding it more difficult to slip their prescriptions past the FDA or find a local outlet willing to help them find cheaper medicine across the border -- a $1 billion industry.

In January 2003, there were at least five Canadian drug outlet storefronts in Brevard County, boasting savings to retirees of between 30 percent and 70 percent.

Now, it appears only two remain: Canada Connection in Rockledge and Senior Care Insurance Advisors in Titusville.

This trend of dwindling Canadian outlets is occurring for two reasons, experts said.

First, the state two years ago issued cease-and-desist orders, threatening jail time to operators of major outlets in that helped import Canadian drugs. Many operations have closed, and others that didn't are trying to fly under the radar.

Second, because of a declining U.S. dollar and shrinking supply, Canadian drugs are getting more expensive, with some local pharmacies and residents saying they have found better deals on medications in this country.

To keep profits up, many of the Internet and mail-order pharmacies that claim they are based in Canada have brought in "international" buying partners, meaning your prescription could be coming from the United Kingdom, Israel, Australia, Chile, South Korea or other countries.

It doesn't matter where they come from to the Florida Department of Health, if they originate out of this country.

State officials say any prescription drugs coming from Canada might not be as safe as medicine in the United States.

Any "re-importation" of drugs without the FDA stamp is breaking the law, even if it's in the same package with the same quantity used in this country.

That argument, however, rings hollow on the federal level, some say.

Instead of trying to find ways to cut off the supply of Canadian drugs to this country, lawmakers are actively trying to legalize drug importation to ease the burden on millions of uninsured Americans and retirees on fixed incomes.

While some provisions to allow the importation of Canadian drugs have pushed through Congress, the FDA has blocked them from being implemented by saying it can't certify drugs from another country are safe, even if the foreign pharmacy from which they originate is legitimate and licensed.

Further, experts say some federal workers and even some states looking to slim down health care budgets that are spiraling out of control get their prescriptions from Canada -- another reason why the government is turning a blind eye.

Medicare changes

Some health experts say there is a seismic shift coming in the Canadian drug-importation business, with the upcoming Medicare drug benefit, called Part D, scheduled to kick off Jan. 1.

It will offer dozens of insurance plans, so that those who can't pay will get the drugs they need and those who pay too much will get some help.

If the $724 billion plan works, it could be a wrecking ball to the U.S. component of the Canadian pharmacy industry, which already is in decline, said Joseph Bast, president of the Heartland Institute, a Chicago-based independent research firm.

"Most of the demand for imported drugs are from seniors, and that will be dramatically reduced" with the new Medicare prescription program, Bast said. "The price difference is not as big, and people are saying it could be dangerous. I think the wind is out of the sails on drug importation."

The danger, Bast said, stems from the fact that Canadian pharmacies simply can't keep up with the demand for cheaper drugs.

As a result, "more and more drugs are 'trans-shipped' through Canada, but made in China and Pakistan," Bast said. "It's less and less safe to import drugs."

Cost differences

But why do Americans pay more and Canadians pay so much less for prescription drugs?

There are several reasons why, said Michael Cannon, director of health-policy studies at the Washington, D.C.-based Cato Institute and author of "Healthy Competition."

Drugs are cheaper in Canada because the Canadian government has negotiated price controls with major pharmaceutical companies, based on international averages.

Canadian provinces also buy certain widely used medicines in bulk, giving them more leverage to drive down prices.

There also are fewer civil lawsuits in Canada, so drug companies pay less for insurance.

Because those price controls aren't in place in this country, the drugs cost more, but that also means this nation has more "innovation and money spent on research and development for new breakthrough drugs," Cannon said.

A drug maker could easily spend $100 million to develop the first pill -- meaning the research and development to get a new drug to market.

And some countries "only want to pay for that second pill," which leaves those in the United States paying the major share of development costs, he said.

If Canada can't find a way to stop many of its pharmacies from sending its drugs to the United States, Cannon said, drug manufacturers could renegotiate the country's price controls and force up the prices for prescription medications.

Of course, if that supply dries up, it means customers of Marielle Sauriol, who has owned Sebastian-based Canada Rx USA for the past two years, could be left to pay prices they say they can't afford.

Gone are the days of clients saving 80 percent, but she said many still can shave 40 percent to 50 percent off the cost of medications, which can mean more money to pay bills or buy groceries.

Sauriol said she knows that many Canadian prescription outlets have shut down, and she is concerned.

"I would not like to get a letter" telling her to stop operating her business, she said. "But even if I did get one telling me to shut down, the pharmacy would continue helping people. I am just the local representative."

She said cracking down on bogus Internet pharmacies should be applauded, but she chose her pharmacy after studying it, talking to the owners and making sure it was licensed.

Sauriol added that she is learning about Medicare Part D to answer questions for her clients and will recommend they switch to it if there are better deals to be had.

Leaving the business

A desire to help seniors struggling with giant prescription-drug bills -- some saying they had to choose to buy groceries or their medicine -- is why West Melbourne resident Lee Hicks started Canada Discount Rx out of the Metro Cinema Cafe movie theater two years ago.

In a few short weeks, he garnered more than 1,000 customers, and estimated he had saved his clients more than $200,000.

Hicks said some clients were so ecstatic to get medicines at half prices and lower, they told him, "God bless you."

But that quick growth caught the attention of the Florida Department of Health, which sent him and other outlets in the state orders to shut down or face fines and jail time.

He wanted to fight it and even got a lawyer representing other outlets.

He said state officials backed out on a promise to "license" outlets under federal laws allowing drug importation.

Unable to win, Hicks two months ago decided to leave both the Canadian import business and, in an unrelated move, the Metro Cinema Cafe, which he sold.

Hicks now is chartering and storing boats.

The state's hard-line stance "drove people underground," Hicks said. "It was scary. They said we were facing three felonies, and 10 to 12 years in prison. But, what I liked about it was I actually did something for people. I made a difference in someone's life."

Independent local pharmacist Ross Clark is sympathetic to those who have gotten their medicines from Canada.

But, he said, in some cases, the price differential is not all that much between a Canadian pharmacy and a traditional local drugstore.

Clark, owner of the Suntree Pharmacy, said the "gulf of prices is closing" on some medicines. "We have a few customers that used Canadian drug markets. But, sometimes, we are still able to come up with better prices."

A potential customer called recently and asked about one medication the person was getting from Canada.

Clark said his price was $30 lower, mainly because "all of the pharmacies in the area are pretty competitive."

Titusville couple Cynthia and Bob DeTorres got many of their prescriptions from Canada until a year ago.

That's when Bob DeTorres did some comparison shopping, and found a local Kmart had his main medication cheaper than he was getting it from Canada.

DeTorres also didn't have to buy a three-month supply, further easing the hit on his wallet.

He estimated he now is saving $80 a month.

And, he added, with all of the controversy related to Canadian drugs, "you don't even know if you will get it. I am really glad I found a local pharmacy where things are a little bit cheaper."

Contact Monroe at 242-3655 or bmonroe@flatoday.net

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Drug prices in Canada

Following are the costs of a 30-day supply of a variety of medications available by prescription. For many mail-order Canadian pharmacies, customers have to order a three-month supply.